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Autoimmune dz affect what part of the kidney?
Drugs and toxins affect what part of the kidney?
- glomerulus
- Interstistium and tubules
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Distribution
Chronic or acute
Systemic symptoms
Inflammation
What are the 5 types of Lupus Nephritis?
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5 types of Lupus Nephritis?
- No change/minima
- Mesangial
- Focal Proliferative
- DIffuse Proliferative--most common TYpe IV
- Membraneous--GBM involvement
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Wire Loop Glomeruli are seen in what systemic autoimmune disease?
SLE
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Which Lupus nephritis has cresents?
Diffuse proliferative nephritis
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PAS positive mesangial cells are seen in what disorder?
Plasma cell Dycriasis
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Bence Jones tubular casts are seen in what condition?
MM affecting the kidney--amorphous pink material
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Subendothelial and mesangial deposits of criss-cross fibrillary pattern are seen in what condition of the kidney?
Amyloidosis
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Flea bitten kidney results from what kidney condition?
Malignant hypertension
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What accounts for the flea bitten appearance of the kidney?
petechial hemorrhages of the glomeular of tubular capillaries
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What are the 2 pathological changes seen in the blood vessels of malignant hypertension?
- fibrinoid necrosis---fibrin, neutrophils
- Onion skinning----collagen, proteoglycans, plasma proteins
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Cause of Renal artery stenosis?
atherosclerosis
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Atherosclerosis differes from Fibromuscular dysplasia how?
- FMD--women in 3rd or 4th decade
- Atherosclerosis--men in 5th or 6th decade
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WHat makes up the casts and obstructs the lumen of the tubule?
necrotic epithelial cells after they loose their polarity from ischemia
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Eosinophilic casts are indicative of what kidney disorder?
Interstitial nephritis due to drug hypersensitivity
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What kind of ischemic injury to epithelial cells lining tubules is seen in toxin caused acute kidney necrosis?
With ischemia?
- PCT
- PCT and ascending loop of henle
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Rupture of basement membrane i.e tubulorrhexis is seen in what acute tubular necrosis? Toxin or ischemic?
Ischemic
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What is responsible for oliguria in Acute tubular necrosis?
sloughed off epithelial cells blocking the lumen of the tubule
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What electrolyte disturbance is seen in the 1st or initiation stage of ATN?
- hyperkalmeia
- metabolic acidosis
- Azotemia--BUN and Creatitine increased
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Muddy brown granular casts are indicative of what?
Acute tubular necrosis
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WBC casts arre indiciative of what?
pyelonephritis and transplant rejection
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RBC casts are indicative of what?
- glomerulonephritis
- ischemia
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2 Causes for Acute tubular necrosis (ATN)
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2 types of Acute tubular necrosis?
- ischemic
- Toxigenic---Drugs, x ray contrast, myoglobin and other foreign substances
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What is the pattern of damage in ischemic vs toxic tubular necrosis?
- ischemic--all parts of nephron affected
- Toxic--only proximal part if affected
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WHat is acute pyelonephritis?
- infection of renal pelvis
- tubules
- interstitium
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2 causes for Renal artery stenosis?
- atherosclerosis
- fibromuscular dysplasia
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What virulence factors are needed by bacteria to colonize distal urethra/
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4 virulence factors of h.pylori?
- urease
- fimbriae
- coxa gene
- pili
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What are the p?redisposing factors to acute pyelonephritis
- distal urethral colonization
- obstruction
- vesicourethral reflux
- intrarenal refulx
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3 glomerulopathies that produce foot processes effacement?
- minimal change dz
- membranous
- Focal segmental glomerulosclerosis
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Diff between membranous and DM nephropahty?
- membranous only has gbm thickning
- dm has gbm thickening, mesangial thickening/nodular glomerulosclerosis
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Hormones produced by the RCC?
- PTH
- Renin
- Corticosteroid
- gonadotropins
- renin
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What caused Diffuse cortical necrosis?
ischemia to the kidney i.e DIC, obstetric complication, atrial/ventricular thrombus
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What causes Acute tubular necrosis?
- ischemia/hypoxia--patchy involvement of the tubules
- toxins--proximal tubules involved
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How does Drug interstitial nephritis present?
eosinophils in urine
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causes of Renal papillary necrosis?
- analgesic nephropathy
- DM
- Sicke cell
- acute pyelonephritis
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Bladder Exstrophy is associated with what other congenital anomaly?
epispadiasis
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Classic pathology of kidney seen with DM?
nodular glomeruloscleorosis in the glomerulus
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4 causes for oligohydramnios?P
- Posteriour urethral valve
- renal agenesis
- Multicystic renal dysplasia
- autosomal recessive
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vasculitis affecting medium sized bv?
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vasculitis affecting large blood vessels?
- takayasu
- Giant cell arteritis
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ARPKD causes what?
- renal cysts
- hepatic cysts
- hepatic fibrosis
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